Lung Ultrasound Versus Dynamic Lung Compliance to Detect the Optimum Positive End-Expiratory Pressure After Alveolar Recruitment for Patients Undergoing Laparoscopic Gastric Sleeve Surgery: A Randomized Trial

Background: Various maneuvers are used to maintain oxygenation and prevent atelectasis and desaturation during general anesthesia in bariatric surgery. These maneuvers include alveolar recruitment (ARM) and positive end-expiratory pressure (PEEP). The current study aimed to illustrate the role of transthoracic lung ultrasound (LUS) as a clinical tool in comparison to dynamic lung compliance Cdyn for the detection of optimum PEEP after ARM for obese patients undergoing laparoscopic gastric sleeve surgery. Materials and Methods: Sixty patients who were scheduled for laparoscopic gastric sleeve surgery, 18-60 years old, of both sex, American Society of Anesthesiologists physical status ASA II, and body mass index BMI>30kg/m2 were enrolled in the study. They were randomly allocated into two groups to detect the optimum PEEP after ARM, group I lung Cdyn (n=30) and group II LUS (n=30). In both groups, hemodynamic parameters HR and MAP, SpO2, PaO2, and PaO2/FiO2 were recorded. A lung ultrasound score (LUSS) was used in the US group. Results:  Both techniques effectively detected optimum PEEP after ARM without significant differences. Hemodynamics (HR, MBP) significantly changed within groups without significant differences between the groups regarding such changes. Regarding SpO2, PaO2, and PaO2/FiO2, there was a considerable increase within groups, especially after ARM, without substantial differences regarding such changes. Postoperative pulmonary complications (PPCS); PaO2<80mmHg, and SpO2<94% were non-significantly more frequent in the Cdyn group. Conclusion: Both lung Cdyn and LUS were effective methods to detect the optimum PEEP needed after ARM in laparoscopic gastric sleeve surgery

"We Want Them All to Speak in English … So, no Spanish": Preservice Teachers' Language Ideologies Towards Emergent Bilinguals

Research Articl

The Neglected World of the Workplace Trainer

The aim of this small-scale research is to explore the hidden world of the workplace trainer. Four trainers from a training institute in Qatar were interviewed and asked about their opinions of the employee as a learner, the trainer’s work, and the role of quality compliance in the training process. After transcribing and analysing the semi- structured interviews, several themes concerning the employee as a learner emerged such as the employees’ motivation and the effects of the workplace environment on learning. The findings also showed the trainers’ need for an adequate professional development plan and a reconsideration of their power inside the classroom. Regarding the quality compliance, there were various insights and suggestions for improvement. The results of this study are important to any workplace trainers, human development, and quality compliance employees or anyone interested in knowing more about the world of adult learning

The Neglected World of the Workplace Trainer

The aim of this small-scale research is to explore the hidden world of the workplace trainer. Four trainers from a training institute in Qatar were interviewed and asked about their opinions of the employee as a learner, the trainer’s work, and the role of quality compliance in the training process. After transcribing and analysing the semi- structured interviews, several themes concerning the employee as a learner emerged such as the employees’ motivation and the effects of the workplace environment on learning. The findings also showed the trainers’ need for an adequate professional development plan and a reconsideration of their power inside the classroom. Regarding the quality compliance, there were various insights and suggestions for improvement. The results of this study are important to any workplace trainers, human development, and quality compliance employees or anyone interested in knowing more about the world of adult learning

Elementary Preservice Teachers’ Language Ideologies and Emergent Bilingual Students

Background: The number of emergent bilingual (EB) students is expanding very quickly in U.S. schools. They are expected to enter an idealized mainstream classroom that does not make use of their cultural and linguistic diversity (Reeves, 2004). There is a lack of preparation for teachers to meet the needs of the increasingly diverse student population. Prior research has also shown that preservice teachers do not feel well-prepared to teach EBs (Durgunoglu & Hughes, 2010). In addition, the prevailing monolingual ideologies present in the U.S. educational system negatively impact teacher practices in the classroom, which often fail to recognize and utilize their EBs’ linguistic capital as resources inside the classrooms. Language ideologies are beliefs about the superiority or inferiority of specific languages, how languages are acquired, and language contact and multilingualism (Kroskrity, 2004). Many of the challenges that educators face in teaching minority students may not be due to technical or methodological issues. Rather, they are rooted in “unacknowledged discriminatory ideologies and practices” (Bartolomé, 2008, p. ix). Purpose: This study explored elementary EC-6 generalist preservice teachers’ (PSTs) language ideologies, the factors influencing them, and their potential impact on PSTs’ instructional planning abilities for EBs. Research questions: Three research questions guided the current study: 1. What are the common and different language ideologies held by elementary PSTs enrolled in a university teacher education program at a major urban city? 2. How might current and past personal language experiences and school language experiences influence their language ideologies and pedagogical orientations? 3. How might these language ideologies influence their instructional planning abilities for emergent bilinguals? Methods: This study used a basic qualitative research design to understand the elementary EC-6 generalist PSTs’ language ideologies. Seven participants were chosen using purposeful sampling from students enrolled in an asynchronous second language methodology course in a teacher education program at an urban university in Southeastern United States. Data collection methods included semi-structured interviews and student work, namely two vblog entries and lesson plans. Braun and Clarke’s (2006) six-process thematic analysis was used to identify themes found from multiple data sources. Trustworthiness was achieved through triangulation, peer debriefing, member checks, and an audit trail. Findings: The findings showed how the PSTs in this study lacked ideological clarity and had conflicts between seeing home language as a problem, a right, and a resource, with their comments evoking multiple contradictory language ideologies simultaneously. These language ideologies were products of their personal, past, and current school experiences and their teaching experiences. Furthermore, PSTs’ language ideologies impacted their instructional abilities for EBs by failing to utilize their EBs’ home languages as a resource. Conclusion: The PSTs’ ideological conflicts may be associated with their schooling experiences in English-only environments where home languages were less valued or used as a resource. Thus, teacher education programs should help PSTs develop ideological clarity (Bartolomé 2004) by encouraging PSTs to constantly examine their language ideologies which may favor monolingualism and language standardization, and instead use students’ funds of knowledge as a resource in lesson planning and teaching practices

QRS dispersion detected in ARVC patients and healthy gene carriers using 252-leads body surface mapping : an explorative study of a potential diagnostic tool for arrhythmogenic right ventricular cardiomyopathy

BACKGROUND: The diagnosis of ARVC remains complex requiring both imaging and electrocardiographic (ECG) techniques. The purpose was therefore to investigate whether QRS dispersion assessed by body surface mapping (BSM) could be used to detect early signs of ARVC, particularly in gene carriers. METHODS: ARVC patients, gene carriers without a history of arrhythmias or structural cardiac changes and healthy controls underwent 12-lead resting ECG, signal-averaged ECG, echocardiographic examination, 24-hours Holter monitoring, and BSM with electrocardiographic imaging. All 252-leads BSM recordings and 12-leads ECG recordings were manually analyzed for QRS durations and QRS dispersion. RESULTS: Eight controls, 12 ARVC patients with definite ARVC and 20 healthy gene carriers were included. The ECG-QRS dispersion was significantly greater in ARVC patients (42 vs. 25 ms, p < .05), but failed to fully differentiate them from controls. The BSM-derived QRS dispersion was also significantly greater in ARVC patients versus controls (65 vs. 29 ms, p < .05) and distinguished 11/12 cases from controls using the cut-off 40msec. The BSM derived QRS dispersion was abnormal (> 40 ms) in 4/20 healthy gene carriers without signs of ARVC, which may indicate early depolarization changes. CONCLUSIONS: QRS dispersion, when assessed by BSM versus 12-lead ECG, seem to better distinguish ARVC patients from controls, and could potentially be used to detect early ARVC in gene carriers. Further studies are required to confirm the value of BSM-QRS dispersion in this respect

The educational value of ward rounds as a learning and teaching opportunity for house officers, medical officers, and registrars in Sudanese hospitals: a multi-center cross-sectional study

Abstract Background Ward rounds are a cornerstone in the educational experience of junior doctors and an essential part of teaching patient care. Here, we aimed to assess the doctors’ perception of ward rounds as an educational opportunity and to identify the obstacles faced in conducting a proper ward round in Sudanese hospitals. Method A cross-sectional study was conducted from the 15th to the 30th of January 2022 among house officers, medical officers, and registrars in about 50 teaching and referral hospitals in Sudan. House officers and medical officers were considered the learners, while specialist registrars were considered the teachers. Doctors’ perceptions were assessed using an online questionnaire, with a 5-level Likert scale to answer questions. Results A total of 2,011 doctors participated in this study (882 house officers, 697 medical officers, and 432 registrars). The participants were aged 26.9 ± 3.2 years, and females constituted about 60% of the sample. An average of 3.1 ± 6.8 ward rounds were conducted per week in our hospitals, with 11.1 ± 20.3 h spent on ward rounds per week. Most doctors agreed that ward rounds are suitable for teaching patient management (91.3%) and diagnostic investigations (89.1%). Almost all the doctors agreed that being interested in teaching (95.1%) and communicating appropriately with the patients (94.7%) make a good teacher in ward rounds. Furthermore, nearly all the doctors agreed that being interested in learning (94.3%) and communicating appropriately with the teacher (94.5%) make a good student on ward rounds. About 92.8% of the doctors stated that the quality of ward rounds could be improved. The most frequently reported obstacles faced during ward rounds were the noise (70%) and lack of privacy (77%) in the ward environment. Conclusion Ward rounds have a special value in teaching patient diagnosis and management. Being interested in teaching/learning and having good communication skills were the two major criteria that make a good teacher/learner. Unfortunately, ward rounds are faced with obstacles related to the ward environment. It is mandatory to ensure the quality of both ward rounds' teaching and environment to optimize the educational value and subsequently improve patient care practice